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ENDO > ENDO Week 11 > Flashcards

ENDO Week 11 Flashcards

(56 cards)

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1
Q

which hormones regulate body fluids and electrolytes

A
  • Arginine Vasopressin (ADH)
  • Aldosterone
  • Angiotensin II
  • Atrial Natriuretic Peptide
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2
Q

what kind of hormone is ADH

A

Peptide hormone

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3
Q

what inhibits ADH actions

A

lithium

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4
Q

where is ADH synthesized and secreted from

A

synthesized from supraoptic in hypothalamus, secreted from posterior pituitary

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5
Q

what causes ADH to be secreted

A

stimulated osmosensitive neurones stimulate magnocellular neurons to release ADH into pp –> released into general circulation

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6
Q

what is a major factor of ADH release

A

plasma osmolality

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7
Q

what pathway does ADH use

A

cAMP

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8
Q

what are the receptors which ADH binds and their responses

A

V1a/V1R: vasopressor
V1b: release of ACTH
V2R: water reabsorption

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9
Q

what is ADHs major action

A

reabsorbing water from renal tubules = increase urine osmolality/ concentration

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10
Q

what is the mechanism of action of ADHs action on kidney

A

Binds V2R receptors of collecting ducts –> cAMP –> Forms aquaporins 2 in collecting ducts –> Water is absorbed by osmosis to the blood

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11
Q

what is the ADH mediated aquaporin and where is it inserted to

A

ADH mediated aquaporin is aquaporin 2 and it inserts into luminal membrane

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12
Q

which ions stimulate ADH

A

ADH is stimulated when sodium chloride is high
- ADH tries to dilute the sodium chloride by adding water

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13
Q

which receptor is responsible for ADHs vasopressor effect and what is its mechanism of action

A
  • V1a/V1R receptor
  • Activates phospholipase C smooth muscle increases intracellular calcium, causing constriction of blood vessels
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14
Q

what does ADH on V1b receptor cause

A

release of ACTH

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15
Q

describe how osmolality affects ADH

A

o Water deprivation –> increases plasma osmolarity –> activates hypothalamic osmoreceptors, stimulates ADH release

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16
Q

what is ADHs effect on ECF volume

A

o Conserves body water, maintains ECF volume

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17
Q

what are the factors affecting ADH secretion

A

o Osmolarity detected by osmoreceptors
o Blood/ECF volume detected by baroreceptors

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18
Q

how does the body lower increased osmolarity

A

Increase osmolarity –> hypothalamic osmoreceptors –> stimulates hypothalamic neurons –> increase thirst –> H2O intake –> decrease plasma osmolarity

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19
Q

how do baroreceptors affect ADH

A

Decrease ECF volume –> decrease arterial blood pressure –> left atrial volume receptors (baroreceptor) –> stimulates hypothalamic neurons –> increased vasopressin (2 actions…)

increased vasopressin –> vasoconstriction –> increases BP

increased vasopressin –> increased water reabsorption in kidney –> increase ECF volume

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20
Q

what does ADH deficiency cause

A

diabetes insipidus

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21
Q

what does diabetes insipidus cause

A

Excretion of abnormally large volumes of dilute urine and excessive thirst

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22
Q

what are the 4 types of diabetes insipidus

A
  • Hypothalamic diabetes insipidus (HDI)
  • Nephrogenic diabetes insipidus (NDI)
  • Gestational DI
  • Dipsogenic diabetes insipidus (DDI)
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23
Q

what is hypothalamic diabetes insipidus and what is its effect on ADH level

Study These Flashcards
A

decreased ADH release = plasma ADH levels are low

24
Q

what is nephrogenic diabetes insipidus and what is its effect on ADH level

Study These Flashcards
A

decreased renal responsiveness to ADH
caused by defect in V2 receptor

ADH levels are high

25
what is gestational DI
deficiency of ADH only during pregnancy, returns to normal after birth
26
what is Dipsogenic diabetes insipidus (DDI)
Inappropriate, excessive water drinking
27
what are the symptoms of DI
polydipsia, polyuria, NO POLYPHAGIA
28
what is the water deprivation test and what is it used for
used to differentiate between cranial DI and nephrogenic DI 1. pt is deprived of water and then given synthetic ADH (desmopressin) 2. If renal is working, urine becomes concentrates with desmopressin 3. Then that means the patent has cranial
29
what is SIADH
syndrome of inappropriate antidiuretic hormone - Too much ADH secretion with inappropriate water retention and decreased blood sodium
30
what is SIADH effect on osmolality
low plasma osmolality and concentrated urine
31
what is SIADH caused by
 Brain injury or tumour production of ADH  Tumour or malignancies in lung or pancreas (ectopic) secreting ADH
32
what is SIADHs effect on sodium concentration
Increase ADH --> urine volume is less and more concentration --> blood volume increases --> sodium is diluted --> hyponatremia (dilutional hyponatremia)
33
what is the treatment of SIADH
V2 receptor blockers
34
what kind of hormone is aldosterone and where is its receptor present
* Steroid hormone * Receptor present in principle cell
35
what is aldosterone effect on BP
Aldosterone --> kidney, increasing Na reabsorption --> increasing blood pressure
36
what is aldosterone synthesized by
angiotensin II
37
what is conns syndrome
o Overproduction of aldosterone
38
what is primary and secondary hyperaldosteronism
Primary hyperaldosteronism - Increase aldosterone --> low plasma renin (gland is the problem) Secondary hyperaldosteronism - increase of renin secretion --> stimulation of angiotensin II and aldosterone productions - not pituitary
39
what are clinical features of conns syndrome
increase aldosterone, hypokalemia, muscle weakness
40
what does hypo and hyper kalemia cause
arrhythmias
41
what does hypoaldosteronism cause
- isolated deficiency: reduced renin - congenital: synthesis of renin is less due to deficiency of enzyme prolonged administration of heparin decreases receptors of angiotensin II in zona glomerulosa, decreases secretion of aldosterone
42
what are the effects of hypoaldosteronism
Hypotension, hyperkalemia, metabolic acidosis
43
what is the RAAS system effect on blood pressure
increases BP
44
what does renin do
renin forms angiotensin II --> stims aldosterone synthesis
45
what is renin secretion increased by
o Hypotension o Sodium depletion
46
what is renin secretion decreased by
o Increased Na and Cl o Angiotensin II o Vasopressin
47
where does the conversion of angiotensin occur
Angiotensin I --> angiotensin II, conversion happens in blood
48
what kind of hormone is angiotensin II
peptide binds to membrane receptor
49
what is the action of angiotensin II
- constricts blood vessels --> increase BP - stims adrenal cortex to secrete aldosterone which increases Na reabsorption and increases thirst mechanism - increases ADH secretion
50
which receptor does angiotensin II act on
AT1 receptor
51
what does angiotensin II maintain
mean arterial pressure
52
what are the 2 types of ANP
Atrial Natriuretic Peptide - released from atria Brain Natriuretic Peptide - released from ventricles
53
what is the action of ANP/BNP
same action increase Na loss increase H2O loss decrease ECF volume decrease blood volume decrease BP
54
where is ANP secreted from
Secreted by atrial cardiac cells
55
what factors stimulate ANP
Increase fluid volume, increase sodium, stretch in atria or ventricles
56
what is ANP's action on body fluid volume and sodium
- increase loss of sodium - Decreases ECF volume --> decreases blood volume --> decreases BP

ENDO (8 decks)

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